Is It All about the Higher Dose? Why Psychoanalytic Therapy Is an Effective Treatment for Major Depression

Abstract

Psychoanalytic therapy is an effective treatment for major depression, especially in the long run. The differential effectiveness of psychoanalytic therapy cannot be fully explained by its higher dose. Distinctive features of psychoanalytic technique (e.g., focusing on patients' dreams, fantasies, sexual experiences or childhood memories) may play an important role in establishing sustained therapeutic change.

Comparing Short- and Long-Term Group Therapy: Seven-Year Follow-Up of a Randomized Clinical Trial

“…We have previously found that punitive and harsh self-introjects change more in LTG than STG [9]. Recent studies comparing psychodynamic therapies of different length and intensity indicated that long-term therapy was more favourable than short-term therapy with regard to depression and interpersonal functioning [2,3,8,10]. …”

Dimensions of Activity in Countertransference and Therapist Reactions: Therapist Reactions During Sessions with Depressed Patients

“…These interaction patterns allow the clearest insight into transference-countertransference dynamics in the therapeutic relationship. De Bei & Montrosi (2013) claim, in line with Jones (2000), that the therapist's and patient's experience, recognition and understanding of these recursive interactions should be linked to therapeutic interventions and compared to the mediating effects of analytic techniques (Zimmermann et al 2014).…”

“…Therefore, the core of this paper lies in identifying the dimensions of how therapists feel and react during the sessions in general. Zimmermann et al (2014) for instance, found support for the mediating effect of psychoanalytic techniques, namely working with countertransference reactions to predict projective identification, hypothesizing that with depressed patients, favourable long term trajectories of depressive symptoms could be achieved. These findings are in line with previous studies (Ablon & Jones 1998;Gaston et al 1998;Hilsenroth et al 2003) and extend them by showing that psychoanalytic therapies are effective.…”

“…In order to enable the detection of a relationship nurturing interaction pattern, a hypothesis concerning the therapist's positive countertransference onto a patient's positive affect was formulated based on the theory that a positive working alliance is pivotal to the treatment outcome (Falkenström et al 2016). As Zimmermann et al (2014) found that a positive introject affiliation mediated long term treatment success, we concentrated on positive affect. In order to determine in what way the patient's affect predicts the therapist's countertransference and vice versa, a regression analysis was performed: running the first sessions' positive feelings (satisfying countertransference) as the independent variable and the single factor positive affect of the first three sessions as the dependent variables, result in F (initial session 1) (1.71) = .697, p = .407 with an R² of .143; F (initial session 2) (1.68) = .127, p = .723 with an R² of .002 and F (initial session 3) (1.64),143, p = .707 with an R² of .002, though no significant correlation.…”

Psychotherapie bei Depression – 2. Teil

“…B. die Metaanalyse von Vittengl et al [8] [9]. Die Nachhaltigkeit wurde von den Autoren auf die deutlich stär-kere Therapiedosis zurückgeführt [10]. In einer RCT [11] konnte im Langzeitverlauf nach drei Jahren eine signifikant stärkere Reduktion der depressiven Symptomatik in einer psychodynamischen Langzeittherapie im Vergleich zu einer systemisch-lösungsorientierten Kurzzeittherapie gezeigt werden, während im Selbstrating nach drei und sieben Monaten nach Therapiebeginn signifikant stärkere Reduktionen sowie höhere Remissionsraten nach sieben bis zwölf Monaten bei systemisch-lösungsorien-tierter Kurzzeittherapie auftraten.…”